Johnny and Roy listened as the television announcer announced a smog alert for the Los Angeles area. They knew that their day would be filled with calls. Mostly respiratory distress type calls from asthmatics or those with other lung conditions. At least they hoped that that would be what their day would be like. They didn't want to think about the other type of call smoggy days brought. Unfortunately, their hopes were dashed when the station's klaxons sounded and the LA County dispatcher sent them on their way.
Captain Stanley strained to see past the smog and fog ahead of the big engine as they eased out onto the highway.
"Watch yourself there, Mike, there're cars everywhere," he told his engineer.
They traveled slowly down the highway, weaving their way through the cars, slowly approaching the accident scene.
"My God," Stanley said to himself upon seeing the accident scene.
About twenty cars and trucks were piled up ahead of them, as if some child had dumped them out of his Matchbox carrying case.
"LA, Station 51 on scene," he spoke into the microphone.
Stanley met with the other four station captains called to the scene. They agreed on assignments quickly. The engine crews would handle the fuel spills and extrications while the squads would handle the medical treatments. Craig Brice was assigned as triage officer. He would decide which patients were treated and transported first, based upon their injuries.
"Worst come, first served," Doug Bedoski muttered, heading back to his squad for supplies.
"Better him than me," Johnny remarked.
"I agree with you there, partner," Roy replied. "I don't want to be the one deciding who doesn't get treated."
"But you gotta admit, Brice is the man for the job," Dougie Parsons added.
They all silently agreed. Brice had the medical knowledge all right. But more importantly, he kept his emotions in check. He would be the one most able to refuse treatment to a severely injured victim because someone else had a better chance of survival. That was what triage was all about.
On the shoulder of the road, the paramedics treated the victims according to Brice's triage orders.
Johnny looked up from his patient and saw a flash of white walk past him.
"Who's that?" Dougie asked.
"Carol Williams, from Rampart," he replied. "She was in the traffic jam behind us and came to help out."
"Good, we can use all we can get!" Dougie replied, inserting an airway into a victim's mouth.
Johnny finished doing all he could do for his victim and flagged down an ambulance attendant to transport him to the hospital. He was about to find his next patient when he heard arguing. He looked over to see Brice and Carol nose to nose.
"I don't care what you've tagged him! I'm going to help him!" she yelled.
"We don't have time for it!" Brice countered. "We've got other patients that might actually have a chance to survive! He doesn't! Now get away from him!"
Carol dropped to her knees next to the victim and started to remove his shirt.
"I don't work for you. I don't have to take orders from you. And I'm off duty, too!" she muttered as she opened the man's airway.
Something in Johnny made him go to her. He knelt down on the opposite side of the victim and started to take vitals.
"What've you got, Carol" he asked.
"He's bleeding heavy from his chest," she said.
Johnny watched as she grabbed instruments from her carry bag. His eyes widened as she started to cut open the man's chest.
"Gage, you better start some heavy duty IV's for me real soon if we want this to work!" she ordered.
"Gage, you better get back to a salvageable patient real soon, or this'll be the last patient you work on," Brice counter-ordered.
Johnny looked at Brice. Then he looked at the determined look on Carol's face as she continued to work on the man. Johnny grabbed a couple of IV bottles.
"Brice, we've got most of the criticals on their way already. I think you can spare us to try to help this guy out," Johnny said as he inserted one of the IV's
"You'll regret this Gage," Brice warned before storming off.
"Get bagging!" Carol snapped, when she realized that the man had stopped breathing.
Johnny mechanically took Carol's orders and watched in awe as she opened the man's chest up. She put her hands in and searched for the source of his bleeding. He looked at the carry bag next to her. In it he saw what looked like an entire surgical and trauma kit. He wondered just what the hell Carol was doing carrying that around in her car. Next thing he knew she had a needle and thread in her hands and was sewing up what appeared to be a blood vessel next to the man's heart!
'Holy shit!' he thought.
Johnny looked down the road a bit. He saw Brice talking with Captain Stanley.
"I'm out of a job," he whispered to himself.
"You're doing great, Gage," Carol encouraged him.
He looked back at her and saw her applying a large trauma dressing to the man's chest.
"He's not out of the woods, but I think we just sent him to the front of the line," she said.
Johnny called for an ambulance attendant to come and take the man.
Carol stood stiffly and walked alongside the stretcher. Johnny followed her to the ambulance.
"I'm sorry if I got you into trouble, Johnny," she said.
"I made my own decision, Carol," he replied. "We're here to save lives. It's more than just our job, we both know that."
She nodded.
"I'll call you later, to let you know if I'm unemployed or not," he said, helping her into the back of the ambulance.
Johnny made his way over to the remaining victims. The ones left were the "walking wounded." They had minor injuries and would wait for transport to the hospital, if they wanted to go at all.
"Gage!" Captain Stanley called.
Johnny heard the serious tone in Stanley's voice. He didn't have to look to see his eyebrows furrowed in frustration.
"I'm guilty as charged, Cap," Johnny started, ready for the reading of the riot act.
"All I can say is, get ready for one hell of an inquiry, John," he replied.
Johnny and Roy gathered their gear in silence. As they stowed it into the squad's compartments, Captain Stanley approached them.
"You go, get your supplies and then get back to the station," he said to them. "Gage, I want to see you in my office in one hour," he added before heading back to the engine.
Roy had heard part of what had happened. He had been too busy with patients of his own to get all of the details of what had happened. This was the first time he'd had alone with Johnny to find out. They got into the squad and headed for Rampart.
"So?" Roy started.
"So what?" Johnny replied tersely.
"So what? Johnny, from what I understand you disobeyed a direct order helping Carol with that guy! You could lose your job!" Roy exclaimed.
"Isn't that guy's life worth it?" Johnny asked.
Roy could only nod. He and Johnny had both disobeyed orders before. He recalled that time early in their paramedic career when they treated Dixie at that MVA. He only hoped Johnny fared as well this time.
When they arrived at the ER, they made their way to the nurse's station and started to replenish their supplies. Johnny was packing several items into a box when he felt a hand on his shoulder. He turned to see Carol at his side.
"Hey, how are you doing?" she asked.
"Well, for the next hour at least, I still have my job," he replied with a half-hearted smile.
"Come with me," she said, taking his arm. "Roy, I'll bring him back to you in just a few minutes," she added.
Johnny followed Carol to the staff lounge. She closed the door behind them, assuring their privacy.
"I wanted to tell you again, how sorry I am," she started.
"And like I told you before, Carol, I made my own decision," he interrupted.
"I called Captain Stanley. I told him that I pulled rank on you and ordered you to help me," she said.
"What?!!" Johnny cried.
"As a registered nurse here at Rampart's Emergency Department, I technically outrank you when it comes to medical knowledge. As the highest medically trained person on scene, I took over patient care and ordered you to assist me," she explained.
"And just what did Craig Brice say when you told him that you were taking over the scene?" Johnny asked, crossing his arms.
"I only took over one patient," she replied.
"And one paramedic," Johnny added.
"I saw the patients that were left. None of them were critical. I deemed you non-essential," she said.
"Oh, gee thanks. Now I'm non-essential," Johnny said, mock-hurt in his voice.
Carol smiled.
"That's what I told your Captain. What you tell him is up to you," she said.
Johnny looked down, pondering just what he would say later on in Stanley's office.
"How is that guy, anyway?" he asked.
"He's in surgery, now. Still not good, but better than if we left him on the highway," she answered.
Johnny sighed. He now knew what he would tell Captain Stanley.
"Now, Carol, are you going to tell me why you're an ER nurse and not and ER doctor?" Johnny asked. "I didn't think they taught surgery to you guys in nursing school. And can't you get into trouble for doing that?"
Carol smiled slightly and sat down. Johnny sat next to her. She tilted her head back on the couch and took a deep breath.
"I was a surgical nurse in a M.A.S.H. unit in Vietnam. Sometimes we didn't have enough doctors to go around. So we nurses took up the slack on the less serious cases. And sometimes, like today, we had to open guys up in the field just so they'd make it to the operating rooms and the doctors," she started. "And yes, I probably will get into trouble, too. Not the first time, though. You should have seen all the toes I stepped on when I started here. Thought Kelly Brackett would have a cow first time he saw me stitching up some guy's cut before he had the chance to even look at it," she added.
"You WERE good out there. Ever thought of being a doctor?" Johnny asked. "You've already got your own little black bag," he added with a smile.
"Yeah, I thought of it. But unfortunately, when I got back to the States other things took precedence," she replied.
Johnny gave her a questioning look.
"My sister died in a car accident. I had to take care of her two girls. So I got the job here at Rampart and put med school on the back burner," she replied.
"What about now?" he asked.
"Now I'm putting my nieces through med school!" she answered proudly.
"That's great, Carol," Johnny said.
"So, what are you going to tell your Captain?" Carol asked, getting back to business.
"The truth," he said.
***
Johnny headed toward Captain Stanley's office. He was nervous but determined. He truly hoped he could get out of this with his job intact. He wasn't as confident now as he was with Roy in the squad as they drove to Rampart earlier. He looked up as Brice exited the office. No words were exchanged. He entered the office and exchanged glances with Stanley, the Chief and Dr. Brackett.
"Have a seat, Gage," Stanley ordered.
He looked at them again, hoping to gauge their expressions for what was coming next.
"Gage," the Chief started. "We will be placing a memo of counsel into your personnel file, noting your failure to follow the orders of the triage officer at a mass casualty incident," he continued.
Johnny was about to reply when the Chief held up his hand, stopping him.
"In light of Ms. Williams statement, her standing at Rampart Hospital and Dr. Brackett's support of her decision to assume care of Mr. Gautier, your patient, that is all we've deemed necessary," he continued on. "Paramedic Brice and I discussed the incident as well. We feel that since you were acting under the guidance of a more advanced-trained person, Ms. Williams, and you were acting in such a way to benefit Mr. Gautier, a memo of counsel would be sufficient. However, any future incidents such as this could result in a letter of misconduct and grounds for dismissal. Is that understood?"
"Yes, sir," Johnny replied quietly.
"Do you have anything to say?" Stanley asked.
"Only that Ms. Williams and I had only the best intentions. We wanted to save that man's life. Ms. Williams was determined to help that man with or without my help. I knew that the other victims out there were stable. I knew if Carol wanted to give that guy a chance, she needed my help," he said. "If that means I get a letter in my file, so be it," he added.
***
Things were tense around the station and hospital for the next few days. There were debates in both departments about whether or not Johnny disobeyed orders or Carol overstepped her bounds as a nurse. Since Mr. Gautier did indeed survive, and his family did nothing but praise Carol and Johnny and thus the Fire Department and the Hospital for having such excellent personnel in their employ, the matter was soon moot. Johnny even found out that that memo of counsel had been removed from his personnel file by the Chief himself. Carol's letter had also been removed.
***
Two weeks later Johnny and Roy dropped off a patient at the ER. Dixie and Carol were at the nurses' station.
"So, Johnny, you coming to dinner tomorrow night?" Carol asked.
"You bet!" he replied.
"Good, Sheila's been asking about you," Carol replied.
Johnny's eyebrows waggled as he smiled.
"Who's Sheila?" Roy asked.
"My niece," Carol answered.
"That cute med student I told you about," Johnny answered.
"I'd say we were back to normal around here. Wouldn't you agree, Roy?" Dixie remarked.
Author's note – I thought it was about time Carol got some credit. Don't you agree? Our unsung heroine of the ER! (No offense, Dix)